Abstract
Background and study aims This study aimed to investigate the diagnostic accuracy and utility of endoscopic
ultrasound-guided fine-needle biopsy (EUS-FNB) performed using a Franseen needle on
solid pancreatic lesions.
Patients and methods This study included 132 consecutive lesions sampled by endoscopic ultrasound-guided
fine needle aspiration (EUS-FNA) using a 22-G conventional needle and 95 consecutive
lesions evaluated by EUS-FNB using a 22-G Franseen needle to evaluate solid pancreatic
lesions at our medical center between July 2013 and November 2018. We used propensity-matched
analysis with adjustment for confounders. Patient data were analyzed retrospectively.
Results Diagnostic accuracy was higher in the Franseen needle group (Group F; 91.6 %, 87 /95)
than in the conventional needle group (Group C; 86.3 %, 82 /95), showing no significant
difference (P = 0.36). In Group F, diagnostic accuracies for pancreatic head lesions and lesions
sampled by transduodenal puncture were 98.0 % (48/49) and 97.9 % (46/47), respectively.
These values were significantly higher than values in Group C (P = 0.013, 0.01). Group F displayed a significantly lower number of punctures. In terms
of differentiating benign from malignant lesions, Group C showed 85.1 % sensitivity
(74/87), 100 % specificity (8/8), 100 % positive predictive value (74/74), and 38.1 %
negative predictive value (8/21), compared to values of 90.1 % (73/81), 100 % (14/14),
100 % (73/73), and 63.6 % (14/22), respectively, in Group F. Sensitivity and negative
predictive value were better in Group F.
Conclusions Franseen needles for EUS-FNB of solid pancreatic lesions offer similar puncture performance
at different lesion sites while requiring fewer punctures than conventional needles.
